FLEX TIME UTILIZATION FORM

 

Employee Name:                                                                                                                Location:      

Flex Day Utilization Plan:

Absence Date

Number of Hours

Time

Comments

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

 

Total Hours Requested:      

 

                                                                                                                                                                                                                                   

Employee Signature (electronic)                                                                                                                                                                              Date

 

TO BE OMPLETED BY ADMINISTRATION

 Approved                                                                         Denied; Rationale:                                                                                                

Flex Time Previous Balance:      

Flex Time New Balance:           

Processed by: